IS PLASTIC SURGERY SAFE?
East Valley Magazine
BY TODD K FARNWORTH, MD

Dying to be thin? This
is the question posed by a recent People Magazine cover story. This is only
one of the several reports lately questioning the safety
of cosmetic surgery. Most reports focus on cases where cosmetic surgery has
resulted in the death of a patient. Many of these reports have discussed deaths
that have occurred that were unrelated to the procedure being preformed, that
could have happened with any type of surgery. But the fact that they happened
to people who really didn’t need the surgery (cosmetic surgery is purely
elective) has drawn great attention. To be sure, you as a potential patient,
and I as a surgeon, should be interested in this important issue. Since cosmetic
surgery is not necessary for a person’s general health, any serious complications
needs to be avoided at all costs.

What is the real risk? One in 57,000 patients may die after having cosmetic
surgery. Significant, non-lethal complications happen in about 1 in 500 cases.

Plastic surgery popularity is increasing. Cosmetic surgery procedures have
increased a dramatic 175% since 1992 according to the American Board of Plastic
Surgeons. The American Society of Plastic Surgeons (ASPS) is the largest organization
of plastic surgeons in the world and was established in 1931. According to
ASPS, the most poplar procedures are liposuction, breast augmentation and eyelid
surgery. 230,865 liposuction procedures were performed in 1999 alone. There
were 167,318 breast augmentation procedures and 142,033 cases of eyelid surgery.
Men represent 11% of people seeking plastic surgery. Men seek liposuction more
often than any other procedure.

Implant Safety. In addition to the safety of different operations available,
the safety of breast implants has been a topic of concern over recent years.
In 1992, the FDA called a halt on the use of silicone gel breast implants for
cosmetic surgery as a result of unsubstantiated reports of a possible relationship
with the connective tissues diseases or immunologic problems. This led to a
large class-action lawsuit. Since then, approximately 20 large, well-designed
studies have shown that there is no connection between silicone gel implants
and the suspected illnesses. With the release of these studies, the tarnished
image of silicone gel implants is improving. The real risks that accompany
breast augmentation center around the rate of capsular contractor or the formation
of a tight scar tissue capsule around the implant, which can occur in 1-5%
of the cases. This is thankfully rare since it can cause distortion of the
implant or even pain. ASPS has played an active role in defining safety of
cosmetic procedures. ASPS provided $3 million to fund breast implant research
and funds research in other areas as well.

Liposuction safety. Many
of the sensational stories reported recently involve deaths after procedures
where liposuction has been part of the operation. Is
liposuction dangerous? The answer is “yes” and “no”.
Any operation can be dangerous if proper safety guidelines are not followed.
It depends on who is performing the surgery, where it is p